Double simultaneous external defibrillation - Revision history

Mholtz: Text replacement - "* " to "*"

2017-07-21T20:06:50Z

Text replacement - "* " to "*"

← Older revision		Revision as of 20:06, 21 July 2017
Line 3:		Line 3:

	==Indications==		==Indications==
	* [[Cardiac arrest]]		*[[Cardiac arrest]]
	* [[Adult_pulseless_arrest#Refractory_Ventricular_Fibrillation\|Refractory ventricular fibrillation]] (rVF)		*[[Adult_pulseless_arrest#Refractory_Ventricular_Fibrillation\|Refractory ventricular fibrillation]] (rVF)

	==Contraindications==		==Contraindications==
	* Spontaneous circulation		*Spontaneous circulation
	* Inability to apply two sets of defibrillation pads without overlapping		*Inability to apply two sets of defibrillation pads without overlapping

	==Equipment Needed==		==Equipment Needed==
	* Two monitors capable of manual defibrillation (both biphasic or both monophasic)		*Two monitors capable of manual defibrillation (both biphasic or both monophasic)
	* Pre-hospital or hospital provider credentialed to perform defibrillation		*Pre-hospital or hospital provider credentialed to perform defibrillation
	* Two sets of defibrillation pads		*Two sets of defibrillation pads

	==Procedure==		==Procedure==
Line 23:		Line 23:

	==Complications==		==Complications==
	* Generally none		*Generally none

	==See Also==		==See Also==
	* [[Cardiac arrest]]		*[[Cardiac arrest]]
	* [[Ventricular fibrillation]]		*[[Ventricular fibrillation]]
	* [[Defibrillation]]		*[[Defibrillation]]

	==References==		==References==

Ostermayer: /* Procedure */

2017-01-04T11:00:53Z

Procedure

← Older revision		Revision as of 11:00, 4 January 2017
Line 20:		Line 20:
	# After ensuring providers are not in contact with the patient, charge and simultaneously activate the defibrillation/shock button on each monitor		# After ensuring providers are not in contact with the patient, charge and simultaneously activate the defibrillation/shock button on each monitor
	# Resume chest compressions		# Resume chest compressions
	# May consider esmolol bolus (0.5 mg/kg) followed by infusion (0.1 mg/kg) for subsequent DSED attempts<ref>Driver BE, Debaty G, Plummer DW, et al. Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with ventricular fibrillation. Resuscitation. 2014; 85(10):1337-1341.</ref>		# May consider esmolol bolus (0.5 mg/kg) followed by infusion (0.1 mg/kg) for subsequent DSED attempts<ref>Driver BE, Debaty G, Plummer DW, et al. Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with ventricular fibrillation. Resuscitation. 2014; 85(10):1337-1341.</ref> or hold epinephrine dosing for a round of CPR to limit cardiac excitation.

	==Complications==		==Complications==

Ostermayer: /* Procedure */

2017-01-04T10:59:41Z

Procedure

← Older revision		Revision as of 10:59, 4 January 2017
Line 16:		Line 16:

	==Procedure==		==Procedure==
	# Apply second set of defibrillation pads (configurations vary)		# Apply second set of defibrillation pads (configurations vary). Generally pads are applied in the same configuration as the existing pads but in adjacent placement. Pads should not be applied on top of one another
	# Charge both monitors to maximum energy level (200J for biphasic, 360J for monophasic)		# Charge both monitors to maximum energy level (200J for biphasic, 360J for monophasic)
	# After ensuring providers are not in contact with the patient, charge and simultaneously activate the defibrillation/shock button on each monitor		# After ensuring providers are not in contact with the patient, charge and simultaneously activate the defibrillation/shock button on each monitor

Zipdoc at 11:24, 3 January 2017

2017-01-03T11:24:40Z

← Older revision		Revision as of 11:24, 3 January 2017
Line 4:		Line 4:
	==Indications==		==Indications==
	* [[Cardiac arrest]]		* [[Cardiac arrest]]
	* ~~Refractory~~ [[ventricular fibrillation]] (rVF)		* [[Adult_pulseless_arrest#Refractory_Ventricular_Fibrillation\|Refractory ventricular fibrillation]] (rVF)

	==Contraindications==		==Contraindications==

Zipdoc at 11:23, 3 January 2017

2017-01-03T11:23:20Z

← Older revision		Revision as of 11:23, 3 January 2017
Line 20:		Line 20:
	# After ensuring providers are not in contact with the patient, charge and simultaneously activate the defibrillation/shock button on each monitor		# After ensuring providers are not in contact with the patient, charge and simultaneously activate the defibrillation/shock button on each monitor
	# Resume chest compressions		# Resume chest compressions
			# May consider esmolol bolus (0.5 mg/kg) followed by infusion (0.1 mg/kg) for subsequent DSED attempts<ref>Driver BE, Debaty G, Plummer DW, et al. Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with ventricular fibrillation. Resuscitation. 2014; 85(10):1337-1341.</ref>

	==Complications==		==Complications==

Mholtz at 02:49, 31 December 2016

2016-12-31T02:49:52Z

← Older revision		Revision as of 02:49, 31 December 2016
Line 1:		Line 1:
	==~~Overview~~==		==Background==
	*In patients suffering from non-traumatic cardiac arrest who exhibit ventricular fibrillation refractory to standard defibrillation, two simultaneous shocks may be considered. This is termed double sequential external defibrillation (DSED) and has been shown to have some effect in terminating VF<ref>Hoch DH, et al. Double sequential external shocks for refractory ventricular fibrillation. J Am Coll Cardiol. 1994; 23(5):1141-5.</ref><ref>Cabanas JG, et al. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases. Prehosp Emerg Care. 2015; 19(1):126-130.</ref>, though existing data on neurologic outcomes conflict. Several large EMS systems currently use DSED in their standing medical orders<ref>Cortez E et al. Use of double sequential external defibrillation for refractory ventricular fibrillation during out-of-hospital cardiac arrest. Resuscitation 2016; 108:82-6.</ref>.		*In patients suffering from non-traumatic cardiac arrest who exhibit ventricular fibrillation refractory to standard defibrillation, two simultaneous shocks may be considered. This is termed double sequential external defibrillation (DSED) and has been shown to have some effect in terminating VF<ref>Hoch DH, et al. Double sequential external shocks for refractory ventricular fibrillation. J Am Coll Cardiol. 1994; 23(5):1141-5.</ref><ref>Cabanas JG, et al. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases. Prehosp Emerg Care. 2015; 19(1):126-130.</ref>, though existing data on neurologic outcomes conflict. Several large EMS systems currently use DSED in their standing medical orders<ref>Cortez E et al. Use of double sequential external defibrillation for refractory ventricular fibrillation during out-of-hospital cardiac arrest. Resuscitation 2016; 108:82-6.</ref>.

Mholtz at 02:49, 31 December 2016

2016-12-31T02:49:31Z

← Older revision		Revision as of 02:49, 31 December 2016
Line 1:		Line 1:
	==Overview==		==Overview==
	In patients suffering from non-traumatic cardiac arrest who exhibit ventricular fibrillation refractory to standard defibrillation, two simultaneous shocks may be considered. This is termed double sequential external defibrillation (DSED) and has been shown to have some effect in terminating VF<ref>Hoch DH, et al. Double sequential external shocks for refractory ventricular fibrillation. J Am Coll Cardiol. 1994; 23(5):1141-5.</ref><ref>Cabanas JG, et al. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases. Prehosp Emerg Care. 2015; 19(1):126-130.</ref>, though existing data on neurologic outcomes conflict. Several large EMS systems currently use DSED in their standing medical orders<ref>Cortez E et al. Use of double sequential external defibrillation for refractory ventricular fibrillation during out-of-hospital cardiac arrest. Resuscitation 2016; 108:82-6.</ref>.		*In patients suffering from non-traumatic cardiac arrest who exhibit ventricular fibrillation refractory to standard defibrillation, two simultaneous shocks may be considered. This is termed double sequential external defibrillation (DSED) and has been shown to have some effect in terminating VF<ref>Hoch DH, et al. Double sequential external shocks for refractory ventricular fibrillation. J Am Coll Cardiol. 1994; 23(5):1141-5.</ref><ref>Cabanas JG, et al. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases. Prehosp Emerg Care. 2015; 19(1):126-130.</ref>, though existing data on neurologic outcomes conflict. Several large EMS systems currently use DSED in their standing medical orders<ref>Cortez E et al. Use of double sequential external defibrillation for refractory ventricular fibrillation during out-of-hospital cardiac arrest. Resuscitation 2016; 108:82-6.</ref>.

	==Indications==		==Indications==
Line 8:		Line 8:
	==Contraindications==		==Contraindications==
	* Spontaneous circulation		* Spontaneous circulation
			* Inability to apply two sets of defibrillation pads without overlapping

	==Equipment Needed==		==Equipment Needed==
Line 16:		Line 17:
	==Procedure==		==Procedure==
	# Apply second set of defibrillation pads (configurations vary)		# Apply second set of defibrillation pads (configurations vary)
	# Charge both monitors to ~~the desired~~ energy level		# Charge both monitors to maximum energy level (200J for biphasic, 360J for monophasic)
	# After ensuring providers are not in contact with the patient, simultaneously activate the defibrillation/shock button on each monitor		# After ensuring providers are not in contact with the patient, charge and simultaneously activate the defibrillation/shock button on each monitor
	# Resume chest compressions		# Resume chest compressions

	==Complications==		==Complications==
	* ~~Ineffective deliver of electrical defibrillation due to overlapping or improperly applied pads~~		* Generally none
	* Inability to apply two sets of defibrillation pads without overlapping

	==See Also==		==See Also==

ClaireLewis: /* Indications */

2016-12-16T17:52:55Z

Indications

← Older revision		Revision as of 17:52, 16 December 2016
Line 3:		Line 3:

	==Indications==		==Indications==
	* ~~Cardiopulmonary~~ arrest		* [[Cardiac arrest]]
	* Refractory ventricular fibrillation (rVF)		* Refractory [[ventricular fibrillation]] (rVF)

	==Contraindications==		==Contraindications==

Zipdoc: removed duplicate 'see also' section

2016-12-13T21:09:06Z

removed duplicate 'see also' section

← Older revision		Revision as of 21:09, 13 December 2016
Line 23:		Line 23:
	* Ineffective deliver of electrical defibrillation due to overlapping or improperly applied pads		* Ineffective deliver of electrical defibrillation due to overlapping or improperly applied pads
	* Inability to apply two sets of defibrillation pads without overlapping		* Inability to apply two sets of defibrillation pads without overlapping

	~~==See Also==~~
	* [[Defibrillation]]

	==See Also==		==See Also==

Zipdoc at 21:08, 13 December 2016

2016-12-13T21:08:12Z

← Older revision		Revision as of 21:08, 13 December 2016
Line 15:		Line 15:

	==Procedure==		==Procedure==
	1. Apply second set of defibrillation pads (configurations vary)		# Apply second set of defibrillation pads (configurations vary)
	2. Charge both monitors to the desired energy level		# Charge both monitors to the desired energy level
	3. After ensuring providers are not in contact with the patient, simultaneously activate the defibrillation/shock button on each monitor		# After ensuring providers are not in contact with the patient, simultaneously activate the defibrillation/shock button on each monitor
	4. Resume chest compressions		# Resume chest compressions

	==Complications==		==Complications==